Does inflammatory vs malignancy in the remarks of ct scan of lungs with 203cc solid mass mean its cancer?

No.: A pneumonia(infammatory) in the lung might look just the same as a lung cancer. In fact if a cancer blocks a major air tube in the klung, a post obstructive(blockage) pneumonia might result. X-ray dr (radiologist) might not be able to tell the difference betwen the two.

No: No. It is at times difficult to differentiate inflammation/infection from a malignancy on ct. Pet/ct may more helpful where there is suspicion. However, this may also limited in differentiating infection/ inflammation from cancer. That being said, imaging does not arrive at a pathological diagnosis. When possible, any suspicion of lung cancer requires pathological confirmation through a biopsy.